AOSpine Classification Systems (Subaxial, Thoracolumbar).

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Abstract

[Indexed for MEDLINE] 3. Eur Spine J. 2024 Apr;33(4):1556-1573. doi: 10.1007/s00586-024-08140-w. Epub 2024 Mar 2. How does vertical laminar fracture impact the decision-making in thoracolumbar fractures? A systematic scoping review and meta-analysis. Aly MM(1)(2), Abdelwahab OA(3), Atteya MME(4), Al-Shoaibi AM(5). Author information: (1)Department of Neurosurgery, Mansoura University, Mansoura, Egypt. drmoali26@gmail.com. (2)Department of Neurosurgery, Prince Mohamed Ben Abdulaziz Hospital, P.O Box 54146, 11514, Riyadh, Saudi Arabia. drmoali26@gmail.com. (3)Faculty of Medicine, Al-Azhar University, Cairo, Egypt. (4)King Fahd Central Hospital, Jazan, Saudi Arabia. (5)Department of Diagnostic Radiology, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia. OBJECTIVE: Although vertical laminar fracture (VLF) is generally considered a severity marker for thoracolumbar fractures (TLFs), its exact role in decision-making has never been established. This scoping review aims to synthesize the research on VLF's role in the decision-making of TLFs. METHODS: A systematic review was conducted following PRISMA guidelines. We searched PubMed, Scopus, and Web of Science from inception to  June 11, 2023, for studies examining the association of VLF in thoracolumbar fractures with dural lacerations, neurological deficits, radiographic parameters, or treatment outcomes. Additionally, experimental studies that analyze the biomechanics of burst fractures with VLF were included. The studies extracted key findings, objectives, and patient population. A meta-analysis was performed for the association of VLF with dural laceration and neurological deficit, and ORs were pooled with a 95% confidence interval (CI). RESULTS: Twenty-eight studies were included in this systematic review, encompassing 2021 patients, and twelve were included in the meta-analysis. According to the main subject of the study, the association of VLF with a dural laceration (n = 14), neurological deficit (n = 4), radiographic parameters (n = 3), thoracolumbar fracture classification (n = 2), and treatment outcome (n = 2). Seven studies with a total of 1010 patients reported a significant association between VLF and neurological deficit (OR = 7.35, 95% CI [3.97, 14.25]; P